MEDICARE: ICOMMUNICARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1598224057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICOMMUNICARE, LLC

Provider Business Mailing Address
First Line	:	105 ORLANDO PL
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-8411
Country	:	US
Telephone Number	:	917-648-7558
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 ORLANDO PL
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-8411
Country	:	US
Telephone Number	:	917-648-7558
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABBE G SIMON
Credential	:	M.A.CCC-SLP
Telephone Number	:	917-648-7558

Provider Enumeration Date	:	03/14/2019
Last Update Date	:	03/14/2019

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Directions to “ICOMMUNICARE, LLC ” Practice Location

Language	Start Address	Practice Location

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